EVENTS

The Comparison Of BIID and GID

I’m sorry, but I’m afraid it has to be another repost today. I’m dealing with some more nastiness right now that hit a bit too close to home. Just couldn’t finish the piece I was working on (“Is Gender Identity Disorder A Disorder?”). I know, I like repetition in titles. It’s a Gertrude Stein “after the flowers of friendship faded friendship faded” kind of thing. Will post it tomorrow, along with part two of my series on fourth wave feminism. This one is originally from Queereka.

BIID, while one of those things that is widely “known of” (in the pub quiz night “ever heard of those people who voluntarily choose to have their limbs amputated” kind of way) is certainly not widely understood. Christina’s article was a wonderfully non-judgmental and well-researched look at the phenomenon. It basically stems from an incongruity between one’s internal “body map”, or the way that the mind or self “expects” the body to be, and the body’s actual physical configuration. This can create a profound sense of alienation, disquiet or disgust associated with a given limb, extremity, sensory ability or virtually any aspect of the body.

As is fairly common to these discussion, Christina referenced comparisons between BIID and GID, Gender Identity Disorder, the underlying condition that drives transsexuality. GID is also a disconnect between internal “body map” and the actual configuration of the physical body, in this case along the lines of gender. It creates a similar sense of alienation, disgust and so on. Specifically, Christina noted a similarity between the types of argument used against an individual with BIID’s right to elect for surgery to ease the incongruity between body and internal self, and noted how many of the same ethical justifications we’ve ultimately formulated for gender transition are applicable to “voluntary’ amputations or other procedures available to individuals with BIID.

These comparisons, however, have a tendency to put me very much on guard. In the comments, I expressed my discomfort with the comparison, with which I have a long and troubled history. I may, however, have jumped the gun a bit and reacted emotionally before giving it full consideration.

Basically, I have an immediate and strongly negative reaction to the comparison of BIID to GID. This is largely based, as said, on a troubled history. Part of that is the degree to which I’ve seen the comparison based on a conception of transition and genital surgery for transsexual people (SRS), particularly women, as being an essentially reductive procedure, the “amputation” and loss of the genitals (rather than a reconfiguring), the idea that transition is a de-sexing of the body (rather than re-sexing), that we are mutilating ourselves, sacrificing something, becoming lesser beings, destroying our bodies, etc. Basically everything that goes along with the framing of transition and SRS in terms of “cutting off your dick”.

An additional element is the frequency with which I’ve seen the comparison trotted out as a means of discrediting transition, or an individual’s right to choose transition, and also a means of justifying various “gatekeeping” models in which very strict requirements are established that one must meet before being “permitted” to transition or receive hormones or surgery or whatever. The argument typically goes: “well what about those crazies who want to cut off their arms and stuff? Should they just be allowed to go ahead and do that?” My initial internal response is “Well, yes. They should. It’s their bodies”, but I am well aware of where that would lead the conversation. For one, they’d immediately dismiss my position as indefensible, they would proceed to provide increasingly exaggerated examples of why an individual should not be permitted to in all instances make decisions regarding their health (suicide being an inevitable example), they would assume that it’s patently absurd of me to think this is okay, and most importantly, it would allow them to frame the discussion around the implicit concept that transition and SRS are indeed a reduction of the body, mutilation, self-inflicted harm and a sacrifice of health or functionality. And no… they aren’t. So instead, my reaction is to focus on why that comparison is inadequate and damaging, and reflects a profound misunderstanding of the nature of transition (and typically also a misogynist assumption of femaleness as being a “lesser” or “inferior” state to maleness).

So when I see the comparisons made, even in an understandable way, such as Christina’s article where it was being used in a more or less perfectly reasonable manner as a touchstone on the bio-ethics of issues of body map, self-conception and related treatments or surgery, I nonetheless have a knee-jerk negative reaction, my tranny sense tingling, my warning klaxons blaring, and every fiber of my being screaming no no no, they’re DIFFERENT!!!

But the thing is, they’re not totally different. And sometimes comparisons between the experiences of different particular groups is perfectly valid, and a useful means of articulating nuanced aspects of the issues surrounding them. Isn’t it a bit selfish of me to insist that just because some people who understand neither BIID nor GID have used the comparison as a means of invalidating the latter that people who are seeking to help build awareness about BIID be not permitted to use the similarities as a means of articulating things like the bio-ethical considerations?

Yes, I hate the negative ends to which this comparison has been applied. But hopefully I would be able to muster the compassion and generosity to not throw a fit when the comparison is applied towards positive ends.

But on the other hand… would it be a lack of compassion to simply ask that care be taken when using this comparison, to do so carefully, with awareness of the negative conclusions that can (and will) be drawn, and take care to articulate the differences that exist between the two conditions?

What I see as the primary difference is precisely that concept of reduction or loss. Alhough concepts of health or optimal human ability are, to a degree, subjective and culturally mediated, I think it’s both valid and possible to posit models of general basic human physical health / ability, and mental health / ability. Relative to such models, the overall psychological benefit of transition in comparison to the physiological harm is much more clear and less ambiguous than in the case of procedures for BIID. There is virtually no actual loss of health or function in the case of transition… the only real example of such we can point to is fertility. All other potential losses are purely socio-cultural. In the case of BIID, however, there is almost by definition a majour loss of function or ability (which is weighed against the possible benefit to mental health). The individual pursuing the treatment may not personally regard it as a loss, but relative to an overall model of optimal human health and ability? I’m afraid it wouldn’t be unreasonable to regard it as such.

I’ve heard statements before to the effect that if we lived in a society where everyone is blind, blindness would not be a disability. Or if we lived in a society where everyone can fly, our current level of mobility would be regarded as a disability. We don’t, however. We live in a sighted, grounded society, and relative to those standards and conditions we have certain things that are regarded as disability and that create difficulties in the lives of those who have them.

However, it’s entirely possible that my own biases, my own negative preconceptions, and a general feeling of squeemishness regarding BIID is playing into the degree to which I dislike the comparison. I’ve been doing advocacy work for too long to be able to just toss aside the possibility of my own privilege and able-ism impacting how I view things.

In the comment thread, it was suggested that my desire to distance myself from BIID was simply do to negative feelings about it, and about disability in general. I don’t feel that was my sole motivation, but I completely can’t rule it out as a factor, either. I reminded myself of how many LGB individuals will sometimes express a desire to distance themselves from the trans community, using arguments such as “they make us look bad” or “what am I supposed to have in common with some freak who wants to cut his dick off?” (motif noted). And furthermore, there is the pattern even within the trans community itself of some transsexuals opposing the “transgender umbrella”, and specifically wanting to distance themselves as much as possible from drag queens, cross-dressers, genderqueer people, etc. Even further, amongst transsexuals you will find straight, femme, androphillic, post-op women wishing to distance themselves from trans lesbians, butch trans women and tomboys, non-ops and so forth. An endless matryoshka nesting doll set of hierarchies and prejudices.

Is that what I was doing? Simply trying to distance myself on the basis of “it will make us look bad!” and not wanting to be associated with a “lesser” class of identity? If I had written a post in which I used a comparison of the treatment of gay men and women to trans men and women as a touchstone in articulating persecution on the basis of deviation from prescribed sexual and gender roles, how would I react to a gay man objecting that I shouldn’t make that comparison? That it is dangerous, and if I do make it, I should only do so while carefully articulating the differences? I think I wouldn’t react very positively, and would likely regard his distaste for the comparison to be motivated by transphobia.

So it seems that I, like everyone, do have some cultural baggage that needs a bit of unpacking, and I should probably do a bit of thinking about my preconceptions of disability. However, this doesn’t for a moment change the fact that comparisons between BIID and GID have been used as a means of discrediting my identity. Nor does it change the firm belief I have that education, clarity and understanding, and the stamping out of misinformation, is of extreme and paramount importance in moving forward towards acceptance of both trans people and other maligned groups, such as those with BIID.

I’m not really sure what exactly to think about all this at the moment. Only that it has me thinking, and questioning my positions. And that’s always a good thing. So thank you, Christina.

Comments

The two are different in terms of the cognitive level at which they act. Mapping sensory input onto parts of the body is a low-level unconscious process, which is performed by a person’s brain, but doesn’t form a fundamental part of who they are. If neurosurgery existed to fix BIID, it wouldn’t change the patient’s personality; it would simply provide them with a fully functioning body. Similarly, by counseling someone to cope with BIID, you’re not forcing them to deny who they really are; you’re helping them to manage a physical disability.

On the other hand, gender identity is a high level process, which forms a fundamental part of who a person is. If neurosurgery existed to change gender identity, then the patient who left the operating theater wouldn’t be fully the same person who entered. Similarly, by counseling someone to “get over” gender identity disorder, you’re asking them to change who they are.

The comparison between BIID and GID is probably the best “Gotcha!” argument that the transphobes have, but it still doesn’t stand up to rational scrutiny.

I see what you are saying about the difference between BIID and GID. Natalie has covered the question of a “cure” for GID elsewhere and it is difficult to see how “curing” someone with GID could leave them the same person they were before.

Is there any indication that BIID and GID are somehow on a continuum of behaviours (is that the right word?) or is their superficial resemblance a red herring?

(Also, you know that a conversation that starts “What about those crazies who…” is never going to end well.)

c.f. cures changing the person and who they are- I’m sure there’s a similar concern in the H.F Austistic community- that a push for a ‘cure for autism’ is a push to change these people and their personalities at a fundamental level.

Yes, there definitely is a backlash against the people trying to “cure” autism. I know because I’m part of that backlash. The community of Autistic adults (some of whom are pretty low functioning but can communicate with effort) strongly opposes the language in which Autism Advocacy is talked about in the mainstream. Most of the most prominent charities in the Autism Community don’t consult with the wishes of autistic adults. Sometimes we even protest their fund raisers because we believe they’re doing more harm than good.

I wouldn’t be the same person if I wasn’t Autistic and not all aspects of my Autism are purely negative.

I’m Autistic and MTF (early in transitioning) I really wish the two communities talked to each other more, because I think they have a lot in common.

Concur on a link between Autisim and GDI, though it is only based on anecdotal experience. R is diagnosed Asburgers, but is on the spectrum. I’ve noticed she tends to have lower body conciousness. She trips a lot. Is this a function of Autisim? I need to do more research.

Interesting. Yes R is clumsy, and I always associate it with her Asbergers as it increases noticibly under any kind of cognitive stress. Not really sure if that is a factor in GID (nor do I really care aside from trying to understand the woman I love better), but I find it interesting your observations match mine

Dyspraxia can be associated with autism but it can also occur on its own. I’m autistic and I have horrible coordination (that gets worse with age) and I suspect I could have dyspraxia, but I’ve never been formally diagnosed with it.

That is one way to look at it, but it becomes a huge mess to understand when we compare it to other cases of disability such as blindness and deafness from birth.

From the perspective of the sighted, blindness surely does look like a disadvantage and it seems difficult to understand why anyone would want to be blind. Yet, among the blind community, that trait has sometimes become an integral part of identity that they would not choose to change (if it were possible).

The sense of loss able-bodied people feel in considering disabilities is deeply rooted in the existing experience of those capacities. So, it is entirely natural to think that people who are losing or have lost their sight would opt for treatments that could restore it. This perspective, however, simply doesn’t fit into any of the mental frameworks of people who never had that feature to begin with.

Physical disabilities are actually the simpler case. If we try to address “cures” for mental disability or atypical neurology, we would be opening a massive Pandora’s Box.

In the end, my conclusion is that it’s neither proper nor advisable for a group of people unaffected or only indirectly involved to make any decisions for another group. Giving people the right to self-determination also means giving them the ability to make choices we would not agree with.

But I think that’s something that depends on the condition. With untreated trans men and women, you have constant suffering in the form of gender dysphoria (I think; I could be wrong on this; are there trans men and women who don’t have gender dysphoria). I can understand if an organization built on suffering (e.g. the Catholic Church) would want to make that state permanent. But the people themselves?

And fwiw, I think I would currently place Gender Identity Disorder (or something like it) in neuropsychiatry.

Natalie, I pestered you enough on Twitter so you know my thoughts about what you should do.

Yes, there are many, many trans folk who don’t have gender dysphoria. MOST trans folk do not have gender dysphoria. This is part of the confusion over the diagnosis of GID, which Natalie tackles in another post.

To what extent do these people seek to transition? The problem, I feel, is that I don’t understand transitioning well enough (yes, Natalie, there is a request artfully hidden there).

I think I’ve understood that it’s not a railway, it’s a smörgåsbord (one of two words modern Swedish* has gifted the english language with). There’s a host of dishes on the table and people pick and choose what they like. Which is how it must work because trans people are a very heterogenous group and have very different needs. Am I right?

What I don’t know enough about are the various dishes and what purpose they say. Each dish exists serves a need that some trans people have. I feel before I can add very much to the discussion beyond quips and clever phrases (and you may think I’m not even doing that) I must understand this. What needs are there and how are they met (or should be met)?

There are a variety of possible social dysphorias. Wanting to “pass” as identified sex, wanting to be treated as identified sex, wanting to be accepted as legitimate member of identified sex, wanting to be conceptualized as a member of identified sex, wanting to be loved as a member of identified sex, wanting to take on cultural roles of identified sex, etc. Someone can experience one or more or all of these, as well as many others, in any combination, and in any varying degrees of relative intensity.

Likewise a variety of morphological dysphorias. Genital dysphoria, endocrinological dysphoria, dysphoria related to breasts, dysphoria related to body hair, dysphoria related to voice, dysphoria related to skeletal structure, etc. These can, again, occur in any combination, and in any degree of intensity.

And then the actual treatments that may or may not be pursued (in any combination!): HRT/EEI, lower surgery, top surgery, FFS, voice surgery, hysterectomy, orchiectomy, laser hair removal, electrolysis, ETC.

And tons and tons of other things too.

Hopefully this gives SOME sense of the immense variety of ways in which gender is experienced and articulated. But I simply CAN’T cover everything. There are as many iterations of human gender and sexuality as there are human beings.

Of course, the significant majority of transsexual people once had gender dysphoria. And I’d probably say that there’s a certain degree of dypshoria (or at least self-consciousness :p ) lingering even after transition. But it’s VASTLY ameliorated by the transitions (and EEI, SRS, whichever treatments were pursued) that led us to being trans people. Or at least led us to being identifiable as such. The people most suffering from gender dysphoria are those who are not yet visible as trans… often even to themselves. And if someone is identifiable as trans, they’re very likely doing a whole hell of a lot better on the dysphoria front than they used to.

Curious. I would say that it’s the other way around. Higher functions are based on lower ones. Disturb one of the lower functions and you disturb everything that builds on it. Disturb one of the higher functions and you get an isolated loss of function – which can be devastating – but not as widespread as if you lose a low-level function.

On thay basis I would maintain that GID is very different from BIID. From a functional perspective SRS has health issues, but no true loss of function. Not like losing an arm. I think the societal disfunction of gender dysphoria, though is signifigant, and a trans person is likely higher functioning In their percieved gender.

Yes, I’d be inclined to agree. There are similarities between GID and BIID, but I can also see parallels to e.g. Generalized Anxiety Disorder. But similarities are not identity. You cannot just assume that what you’ve learned about one group transfers to another.

And I would be cautious comparing groups of transsexuals to one another as well. If I understand correctly there’s immense variation among trans people. Are these differences clinically significant? Are they a sign that there are several causes that can lead to GID? That there are several conditions lumped together? Hell if I know.

For instance, take SRS. Some trans people want it, others don’t think it’s necessary. Could that be a clue to different origins? Maybe those who want SRS have a body map issue while the others don’t. It’s never that simple of course, but something like that. And of course there may be financial and other reasons not to undergo SRS.

Natalie,
Please take as long a break as you need to properly recover from the horrible blows you have been dealt recently.
You are obviously a driven, dedicated, and amazing person but if you push yourself too hard you could have a breakdown and end up with severe depression. I have been down that road, it is a real dead end…
Sending you as much love, respect, admiration and every other good empowering word as I can.

Take as much time as you need Natalie- I love reading your posts but given the choice I think we’d all rather that you took as long a break or a hiatus or vacation or whatever you needed to work though life throws at you. Hope things look up soon.

This. You are awesome, but you’re still human and you can’t do everything. Do what you need to, and take some time to recover, then take a bit more time because you are clearly driven and maybe push yourself too hard sometimes. We’ll still be here and we’d all much rather you were happy and not overwhelmed by everything.

Hmm, well I checked now and I see that Natalie elaborated a little about it in her twitter feed. Someone who claims to be a trans woman did the in-group-internalized oppression thing and sent her a nasty sexually objectifying comment. It’s sad when people do that.

I think the trans people who read and enjoy this blog, even if every person does not agree with every last syllable, outnumber the negative ones by a huge margin.

If you’re a trans person who enjoys her blogging I’m sure she’d like to hear from you.

Try not to get worried, try not to turn on to
Problems that upset you, oh.
Don’t you know
Everything’s alright, yes, everything’s fine.
And we want you to sleep well tonight.
Let the world turn without you tonight.
If we try, we’ll get by, so forget all about us tonight

Yeah, that sucks. But you have built yourself a mini web community with at least ten times that many trans women who are on your side who have commented or emailed you. I hope some of them will remind you of why your work matters to them.

About the nasty comment: Your cartoon avatar is actually not particularly misleading, it really looks like a slightly manga-ish cartoon drawing of you and it does not look like an attempt to make you look more attractive. There’s also nothing wrong with the video you posted. I thought you made a pretty charming appearance. She probably made those things up because that was the only material that she had to “work with”.

I realize those two details were not the most hurtful parts of it, though. I don’t feel extremely comfortable discussing the other aspect of it here in your space, except this; is there anyone who has had a perfect love-life at every instant in their life? Seriously? Even people without any disadvantages whatsoever have times in their lives, probably longer than a lot of people want to admit, when they can’t realistically give that part of life the focus that it needs in order to be fulfilling… or existent…

Anyway don’t sweat about the blogging. At this pace we almost have time to read everything that you write.

Something I find interesting about this article and also some of the comments is the apparent lack of importance attached to fertility. Now don’t get me wrong, I don’t value it that highly myself, but I find it noteworthy.
For example, German criminal law places the loss of fertility (reproductive function, though not sexual function) as equivalent to the complete loss of an eye, hearing or a limb.
Personally I value even my little finger higher than my fertility, but I wonder whether I’m in the minority with this view.
I vaguely remember a cultural narrative that being infertile is devastating, especially for women, but I really don’t get it.
It could be a generational thing, or it could be something specific to the group of people here. I really don’t know what to make of it, but it’s interesting to hear your thoughts on this.

Interesting observation. I wonder what a survey of trans women would find as far as how much fertility is valued. My own experience was that I had no interest at all in having children, and so I took no precautions to preserve fertility. After it was too late to do anything about it, some sort of latent circuitry was activated, and I began to experience flashes of a totally unfamiliar and unexpected yearning to care for a baby. I sort of suspect this was brought on by changes in hormones, but I really don’t know. It was such a surprising and intense feeling that it makes me wonder whether others have experienced anything similar.

I have moments, but they’re fleeting. I never wanted any children, because I know the commitments they would have required me to make. The one really serious relationship I had before transition, my then-partner started talking about children and it filled me with quiet dread. I did not want to be a dad.

I never banked any sperm or took any other steps before transition, as the only way I was even remotely interested in a biological child would have been if I had been the mother, and even those moments passed quickly. So fertility has never been an issue for me, and even if I can’t give birth I still find being female infinitely preferable to my former state.

People who seek amputations (and are otherwise “trans-abled”) typically don’t view amputation as a loss or reduction; they view it as becoming whole, and often articulate their desire for body/identity congruity in those terms (rather than “being rid of” the offending body part). So it seems like that both trans* folks and people with BIID are harmfully mischaracterized by having their transitions discussed in terms of loss rather than reconfiguration.

An interesting resource on the topic is Transabled.org. They’ve caught a lot of flak for using “trans-” terminology, but a lot of the forum members are transgender as well as transabled, and they claim the dysphoria they experience re:gender is actually quite similar to the dysphoria they experience re:ability level/body configuration.

If you cut off the signals leading from the limb to the brain you can get a condition where the patient vigorously denies that the limb is hirs and express a desire to be rid of it. And when you restore the proper signal flow, the condition disappears. Now, people with BIID don’t deny that the limb is theirs (I think) but it shows how easy it is to alter a person’s body map. And Ramachandran has shown that with a relatively simple procedure you can remove a patient’s phantom limb.

Damn, Natalie – you’ve had a time of it lately! To repeat what others have said, take your break, we’ll be here when you get back. And I’m starting to think I need to be on Twitter just to keep up with you. With all you manage to cram into a day, I have to ask: when do you sleep?! Because I think I would disintegrate under the pressure you bear so well.

So try to get some rest time somehow and I’ll be happy to read any reposts you put up. I’m not even half way thru your back catalogue.

I’d say something violent and nasty about idiots in the twitter-verse, but I’m trying to be a nicer person.

Second, I think I’m going to say that I think we really need to question the idea that changing one’s identity is bad or that having whatever identity you want is some kind of fundamental human right. I’m not saying the opposite, either; you trans people put up with too much crap from mainstream society. But once one enters the social justice bubble, this becomes some kind of truth that can never be criticized.

Also, I think that an objective view of body ability is still a good thing to have.

THere are also ‘otherkin’ (trans-species, sometimes to fictional species like dragons or whatever) and ‘trans-ethnics’. My opinion is that the majority (but NOT the entirety) of both those groups are BS. People having need to be special and stuff like that, or appropriating your ‘horror and glory’.

As to the disability and ability aspect, my reaction has been ‘I want to become stronger’. I am planning to give myself a magnetic sense for example, once I obtain the necessarily materials. I am not defined by my body’s capabilities. I suppose you could say I’m just privileged, but I am able to think of more things than what exists for me or for anybody.

I have heard that there are also people with BIID who feel like they have an extra limb, a phantom, despite having no amputation or anything. I have also heard that techniques used to treat normal phantom limbs can remove some BIID.

If we include ‘otherkin’ in the same category as BIID and GID then we must throw out the body map hypothesis. There’s a lot of plausibility in the idea that a person’s body map may be missing a part, or have this set of genitalia rather than that. There is no plausibility in assuming that the body maps jumps 55 million up the evolutionary tree and then runs down another branch 55 million years. Not to mention dragons.

Being a transhumanist but not transgender, I think the major theme that ties both together is the conflict between bodily autonomy and societal expectations. But similarities don’t extend much further.

Disclaimer: Scarequotes are meant to highlight the choice of words and phrases I have seen used to describe both, not to imply that I think there’s anything wrong with it.
For people with BIID or GID there seems to be something “wrong” about there bodies that can be made “right”, many transhumanists seem to think in categories of “improving abilities” and “expanding possibilities”, but depending on the specific flavour of transhumanism many could not say exactly what would constitute “right” for them.

There’s a lot of potential for conflict between people with BIID and transhumanists, thinking about human enhancement in non-ableist ways is fucking difficult to say the least.
Personally, I find people who want a disability or who do not want to get rid of their disability impossible to understand. That’s not to invalidate their feelings and opinions, but I’m completely unable to relate to them.
But then, many people would probably find the thought of having armor plating or artillery pieces added to their bodies, or having their consciousness uploaded into a computer unsettling, but those are things that I can relate to.
So we need to find a way to establish mutual respect of each other’s identity.

That’s probably the biggest caveat in transhumanism, if you try
separate its goals from social equity and bodily autonomy it converges towards fascism at an alarming rate.

I don’t think there is a way to define body ability in a meaningful way, because every ability that you have has a downside to it and consequently the loss of that ability has benefits. For example, a deaf person can sleep normally when their neighbor is having a party. I would like to be able to turn off my hearing at will. I think that would be an important ability.

This way of defining ability seems to lead to the idea that ability is choice which seems to lead to something like the molten metal terminator model as the ultimate way to be… But I’m not sure everyone would like to be like that either.

Limitation – whether permanent, semi-permanent or short-term – can be liberating for a person.

Rats. Intent not magic. Realistically, I should have seen that coming. At least we have nested replies here.
Transhumanism does have a few lessons in this matter. All people in discussions of ablelism should remember that it exists.

In cases of blind people not wanting to see, etc. With our current techlevel that is 1. rarely possible 2. ends up not being very effective 3. has costs including that your non-visual supersenses are now redundant. People often don’t have to make the actual choice of whether they want to become stronger.

I get pretty frustrated when talking about people who don’t want to be immortal. My possibly-horrible standard response to that is, “how about I coerce you to take the Elixer of Life and then allow you to commit (assisted or self) suicide when you want to.”

Huh. Normal immortality (stuck forever alive) seems pretty horrid to me, but merely being less fragile and having to actively chose to die doesn’t seem bad to me. Except for what the social implications would be if that were the case for everyone, if the rigidness of people’s ways did not change as well.

Hi,
I’ve been reading your blog for some time now. I’m not transgender, but my boyfriend is.
I just wanted you to know that, in vulgar terms, you’ve taught me a bunch of cool or important stuff and you rock.
There isn’t much I can do, and you don’t need my personal approval for anything, but if you need to take some time off or do anything else, please do so. I want to see you get better.
Take care.

<blockquoteThe argument typically goes: “well what about those crazies who want to cut off their arms and stuff? Should they just be allowed to go ahead and do that?” My initial internal response is “Well, yes. They should. It’s their bodies”,
This was my initial response, too, and it’s continues to be my response.

As someone without BIID, the thought of losing one of my limbs is horrific, in terms of pain, body identity, and function. The thought of someone else losing a limb evokes a similar, empathetic response in me.

But it’s not okay to force someone else to suffer to prevent my own discomfort. If an aspect of someone’s body is causing them suffering, and if surgery is the only way to alleviate that suffering, then surgery it must be.

It’s not my body, and it’s not my choice to make. People with BIID aren’t trying to hurt themselves, they’re trying to make themselves whole when faced with a dilemma that I almost certainly will never be confronted with. I need to respect that.

Also, Natalie, I’m sorry you’re having a hard time. I’m having a hard time, too. It sucks. Boo on hard times.